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NPI Code Detail

MEDICARE: DR. DAVID W. SELVIG DDS

MEDICARE: DR. DAVID W. SELVIG DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0221XPediatric DentistryDS020210LPA

General Provider Information

NPI Number : 1083784268
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID W. SELVIG DDS
Provider Business Mailing Address
First Line : 1600 PACIFIC AVE
Second Line : SUITE 1
City : NATRONA HEIGHTS
State : PA
Zip : 15065-2138
Country : US
Telephone Number : 724-224-0790
Fax Number : 724-224-2136
Provider Business Practice Location Address
First Line : 1600 PACIFIC AVE
Second Line : SUITE 1
City : NATRONA HEIGHTS
State : PA
Zip : 15065-2138
Country : US
Telephone Number : 724-224-0790
Fax Number : 724-224-2136
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2006
Last Update Date : 07/08/2007

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